MS, University of Cincinnati, 2019, Allied Health Sciences: Nutrition

Objectives: The objective of this pilot study was to develop and implement the “Most Diabetes and Health Friendly” Shelf Initiative in an urban choice food pantry. Methods: The “Most Diabetes & Health Friendly” shelf initiative was developed using grocery store marketing techniques and community based participatory research (CBPR). The program aimed to assist food pantry clients in identifying healthier food options available in a choice-food pantry. The criteria for healthier food options were established based on a literature review and current dietary recommendations. The healthiest options within each pantry section were highlighted using grocery store marketing techniques: priming, colored labeling, framing, and placement. The initiative was pilot tested in a choice pantry in Cincinnati, OH and usage was tracked for 6 months. The number of items on the intervention shelf versus general shelf was counted before and after pantry sessions. The total number items available, number items taken, and percentage items taken was tracked, calculated, then compared by section and shelf. Results: A higher total number of items was taken from the intervention shelf (1987 items) compared to the general shelf (1863 items). The intervention shelf had a higher percentage of items taken per month (32-47%) compared to the general shelf (25-45%); however, the percentage items taken from the general shelf increased overtime. There was no clear pattern of choices shown across food sections. Conclusions and Implications: Findings suggested the initiative was feasible to implement within a choice food pantry. A higher percentage of food items were taken from the intervention shelves compared to regular shelves. Further qualitative research is needed to determine whether the initiative is able to impact food pantry client's dietary intake, as well as which outside factors most influence food choices within this population.

Committee: Seung-Yeon Lee Ph.D. (Committee Chair); Francoise Knox Kazimierczuk Ph.D. (Committee Member) Subjects: Nutrition

Doctor of Philosophy, Case Western Reserve University, 0, Epidemiology and Biostatistics

This dissertation explores the nutritional quality of food that moves through the hunger relief system before it becomes available to clients, with focus on the COVID-19 pandemic related food supply and policy contexts. Previous evidence documenting the relationship between food availability and food item selection suggests that improving the pantry inventory can improve the quality of foods that clients take home for consumption. Chapter 2 illustrates the trends in food procurement by food banks through four major food sources from 2018 to 2020; and evaluates the change in healthfulness of inventory by comparing the change in pounds of fresh fruits and vegetables (healthy) to desserts and snacks (unhealthy). The results showed that federal food streams and purchased foods were crucial food sourcing levers used by the food banks to meet the increased food demand during the COVID-19 pandemic; while the proportion of inventory comprised of produce decreased in 2020 from 2019, it increased in overall poundage by over a million pounds; and snacks and desserts continued a declining trend both in proportion and poundage, from 2018 through 2020. Chapter 3 investigates the quality of the sourced inventory by partnered programs from the food banks. This aim shows that food procured from federal sources were of the highest quality, followed by food received as donations. Although the program-level characteristics such as location, size, and intervention were not associated with the overall nutritional quality of inventory, programs with the highest proportion of pounds of federal and donated foods had better nutritional quality, as did programs with the lowest proportion of dry inventory. Given the significance of federal food sources in the previous two aims, chapter 4 pivots to investigate the impact of TEFAP disbursement methods (Choice, No-Choice, Modified-Choice) on the quality of pantry-sourced food over time. Although there were no significant differences observed betw (open full item for complete abstract)

Committee: Erika Trapl (Advisor); Caitlin Caspi (Committee Member); Douglas Gunzler (Committee Member); Jin Kim-Mozeleski (Committee Chair); Farren Briggs (Committee Member) Subjects: Nutrition; Public Health; Public Policy

MS, University of Cincinnati, 2019, Allied Health Sciences: Nutrition

Objective: The “Most Diabetes and Health Friendly Shelves Initiative” was designed to help choice food pantry clients improve their food choices to prevent or manage diabetes or other diet-related chronic diseases. The objective of this study was to assess perceptions about the initiative and any changes in food choices and shopping behaviors after the initiative was implemented at a choice food pantry. Methods: A cross sectional quantitative study was conducted using a self-administered survey. Fifty food pantry clients completed the survey after eight months of implementing the initiative at an urban choice food pantry. “The Most Diabetes and Health Friendly Shelves Initiative,” was designed in collaboration with choice pantry staff, volunteers, and clientele. The initiative involved sections of food shelves at the choice food pantry, contain healthier food options and they are marked with green tape and magnets. The goal of the initiative was to facilitate clients to choose healthier food options in an easy and quick way. A poster to introduce the initiative was hung around the pantry and an education brochure was distributed to clients. The survey was composed of demographics and 60 questions on perceptions about the initiative and food choices and shopping behaviors at the food pantry as well as the grocery store. Descriptive statistics were conducted using IBM SPSS Statistics 24. Results: The majority of participants were Non-Hispanic White (58%), females (58%). Less than half (44%) had high blood pressure and one-quarter (24%) had diabetes. Most participants (72%) perceived the shelves as helpful in managing or preventing diet related chronic diseases. The poster and brochure were perceived easy/very easy to use (55%, 63%) and understand (78% ,88%), respectively. The most frequently reported food items taken from the shelves included canned vegetables (82%), canned fruit (80%), and beans (74%). Participants reported that they started reading Nutritio (open full item for complete abstract)

Committee: Seung-Yeon Lee Ph.D. (Committee Chair); Melinda Butsch-Kovacic Ph.D. (Committee Member) Subjects: Nutrition

Doctor of Philosophy, The Ohio State University, 2018, Sociology

Economic insecurity is part of many college students' daily lives. In this dissertation, I investigate food insecurity as a key manifestation of student economic insecurity. I study both individual experiences of food insecurity and institutional responses to student food insecurity through the adoption of on-campus food pantries. I specifically focus on food insecurity because it illuminates both student economic insecurity and the response of colleges to vulnerability on campus. My focus on food insecurity also allows me to develop a theoretical underpinning around institutions' indirect facilitation of students' short term economic security projects, wherein institutions may seek to mitigate students' lack of familial or government safety nets through the provision of security buffer services, such as an on-campus food pantry. In doing so, I speak not only to the issue of individual student food insecurity, but also to institutional responses to this insecurity. I compiled the data for this dissertation through extensive original data collection combined with existing data, from sources that included college websites, Barron's measures of college selectivity, data from the College Scorecard and Integrated Postsecondary Education Data System (IPEDS), and a survey module on student food insecurity that I administered at 44 public two-year and four-year institutions to random samples of undergraduate students (n = 15,252 students). I am able to leverage these unique data sources in tandem to build and expand on the prior research on food insecurity among students. These data allow me to investigate institutional responses to food insecurity across the higher education sector, including for-profit institutions and private non-profit institutions, which have not yet been explored in the existing literature. Additionally, I develop estimates of student food insecurity in differing institutional contexts, providing further confirmation of food insecurity as an issue (open full item for complete abstract)

Committee: Rachel Dwyer (Advisor); Vincent Roscigno (Committee Member); Kara Young (Committee Member) Subjects: Education; Educational Sociology; Higher Education; Sociology

MS, University of Cincinnati, 2018, Allied Health Sciences: Nutrition

Objective. The purpose of this study is to develop an instrument that measures the food literacy and home food environment for urban food pantry clients and test the face validity of the developed instrument with food pantry clients. Methods. Standardized cognitive interviews with food pantry clients were conducted to test the face validity of this instrument at an urban food pantry in Northside, OH. Results. Seven items were necessary to improve clarity of language, provide adequate response options and reduce to the bias or assumptions. The instrument overall was seen to be appropriate for food pantry clients Conclusion. Necessary edits were made to make the Home Food Environment and Food Literacy tool more valid for urban food pantry clients in Northside, OH. Further research is necessary to test other types of validity and reliability of the Home Food Environment and Food Literacy tool in food insecure populations.

Committee: Seung-Yeon Lee Ph.D. (Committee Chair); Sarah Couch Ph.D. (Committee Member); Debra Krummel Ph.D. (Committee Member) Subjects: Nutrition

MS, University of Cincinnati, 2018, Allied Health Sciences: Nutrition

Background: Food literacy is defined by the interactions of an individuals' knowledge, skills, and self-efficacy required to plan, manage, select, prepare, and eat food to meet nutritional needs in a way that supports resilience over time. Positive dietary behaviors are associated with higher food literacy scores across multiple populations. However, there is no valid instrument to measure food literacy. Objective: The purpose of this study is to develop an instrument to measure food literacy and to determine its face validity in a community population of food pantry users. Methods: A comprehensive assessment tool to measure food literacy was developed to assess knowledge, self-efficacy, and skills of the components of food literacy. Cognitive interviews were used to assess face validity of the Food Literacy Assessment Tool (FLAT) in clients at an urban food pantry. Results: After cognitive interviews, the most common issues found in the FLAT from 10 respondents were instruction errors, clarity issues, assumption errors, knowledge or memory issues, bias, and inappropriate response categories or options. Four sections were amended to improve understanding of instructions. Sixteen items were amended based on ambiguity issues. Inappropriate assumptions were also present throughout, and fifteen items were amended to reduce these errors. Three items had knowledge or memory issues. Two items were found to be biased. The subsets of behavior and knowledge went through extensive response option changes after issues arose with these questions. Conclusion: The cognitive interviews with urban food pantry clients provided feedback which improved face validity of the FLAT by increasing the clarity of items in the survey and reduced assumptions and bias.

Committee: Seung-Yeon Lee Ph.D. (Committee Chair); Sarah Couch Ph.D. (Committee Member); Debra Krummel Ph.D. (Committee Member) Subjects: Nutrition

MS, University of Cincinnati, 2018, Allied Health Sciences: Nutrition

Objective The purpose of this study is to assess the interest and feasibility of implementing food donation guidelines at food pantries in Greater Cincinnati. Methods A cross-sectional study was conducted using an electronic survey with 31 food pantry coordinators. The survey explored food donation and distribution practices as well as feedback on an example donation flyer that requested healthful foods that aligned with MyPlate. Results Over 75% of food pantry coordinators expressed interest in using the food donation flyer. Almost half of the coordinators were interested in receiving training regarding how to implement the guideline that would support the use of the donation flyer. The donation flyer generally received positive feedback regarding the visual appeal and content with suggestions to include non-food items and the ability to customize the flyer based on the pantry's specific needs. Conclusion This study found that pantries in Greater Cincinnati are interested in using a donation flyer that requests healthful foods from donors. Interest, time and resources vary across pantries and barriers exist to tracking donation inventory and implementing food donation guidelines.

Committee: Seung-Yeon Lee Ph.D. (Committee Chair); Sarah Couch Ph.D. (Committee Member); Debra Krummel Ph.D. (Committee Member) Subjects: Nutrition

MS, University of Cincinnati, 2016, Allied Health Sciences: Nutrition

Objectives: To explore the availability of food and nutrition education at food pantries and assess the perceived barriers and needs to offer nutrition education to pantry clients. Methods: Food pantry coordinators (N=41) in an urban area completed a survey and an in-depth interview. The coordinators (mean age = 63.4 ± 9.1 years) were mostly non-Hispanic white (73%), female (73%) and well educated (at least a bachelor's degree, 61%). Surveys collected demographic and food availability information while in-depth interviews focused on assessing the perceived barriers and resources needed to offer nutrition education on site. Survey data was analyzed using SPSS and interviews were transcribed verbatim and analyzed with NVivo following content analysis. Results: Seventy-five percent of food pantries offered choice distribution where clients selected items. Fresh produce and foods that were reduced fat, low-sodium, or whole grain/multi-grain were not as available as the less healthy counterparts. Few pantries (29%) offered nutrition education for clients. Needs identified to provide nutrition education were personnel with nutrition expertise, nutrition information, and space. Barriers to promoting healthy eating were limited availability of healthy foods and perceived limits in client nutrition knowledge and interest in nutrition education. Conclusions and Implications: Fresh food options or foods with reduced sodium or fat or whole grains, had lower availability at pantries. Few pantries offered nutrition education to clients. Improving the storage capacity of food pantries and effective strategies to acquire donations are key to making healthy items more available. Collaborative efforts among food pantry coordinators, community partners, and nutrition experts may help improve the availability of healthy foods and nutrition education at local food pantries.

Committee: Seung-Yeon Lee Ph.D. (Committee Chair); Debra Ann Krummel Ph.D. (Committee Member) Subjects: Nutrition

Master of Science, The Ohio State University, 2014, Allied Medical Professions

Food insecurity in U.S. households increased from 11% in 2005 to 14.6% in 2008, and these numbers have remained steady. Forty-nine million Americans and 2 million Ohioans are currently facing food insecurity. Food insecure individuals are often forced to utilize food pantries and other social services to meet dietary needs and are more vulnerable to poor nutritional status. In addition, these individuals are at an increased risk for chronic diseases such as obesity, diabetes, heart disease, and cancer. The purpose of this thesis was to describe the characteristics of a sample of food pantry shoppers in Central Ohio and to determine the frequency of self-reported health conditions and concordance to health recommendations in this cohort. A sample of 251 English-speaking adults completed surveys in semi-private locations within five central Ohio food pantries. The majority of food pantry clients were female (71.3%), White or Caucasian (51.4%), and unemployed (67.7%). Over forty percent were disabled or had a physical limitation that impacted their daily activities. Over 29% did not have health insurance coverage and many reported using the emergency department (23.1%) or urgent care (4.9%) when they needed medical assistance. Rates of hypertension (41.4%), overweight or obesity (37.9%), high cholesterol (26.3%), diabetes (15.1%) and heart disease (8.4%) were higher than county, state and national averages. Subjects did not meet health recommendations for cervical cancer screenings (23.6%), mammograms (47.5%), flu shots (52.4%) and prostate cancer screenings (63.8%). These data reveal disparities in health and adherence to health recommendations in a vulnerable population and highlight the need to design and implement targeted interventions to improve health outcomes.

Committee: Colleen Spees PhD (Advisor) Subjects: Health; Health Sciences; Nutrition; Public Health

Master of Science, The Ohio State University, 2011, Allied Medical Professions

The changing demographics of food pantry users, including an increase in children, older adults, and diverse populations, requires an examination of the needs and preferences of food pantry clients. Information relative to needs, types, and amount of food from families who rely on food pantries for foods is very important in creating a pantry that best meets the clients' preferences. The objective of this study was to examine the current food usage patterns, habits, and preferences of food pantry clients to make recommendations for improvement in food pantry distribution. The analysis is based upon 64 interviews with food pantry clients throughout Central Ohio, conducted from February through April 2011. The threaded open-ended questionnaire was developed by experts in food pantry delivery. Data transcribed from the audio-recorded interviews were analyzed by identifying, coding, and categorizing primary patterns/themes in the data. Three themes emerged and highlight that food pantry clients report (1) a need for more food, (2) preferred having a choice in the foods they received, and (3) were appreciative of pantry services. In addition sub-themes noted that food pantry clients need toiletries and would like some nutrition education for the chronically ill family members. The findings suggest the need for food pantry distribution to allow choice and for a need to distribute more food per family member.

Committee: Kay Wolf PhD, RD, LD (Advisor); Diane Habash PhD, RD, LD (Committee Member); Jill Clutter PhD (Committee Member) Subjects: Nutrition

Master of Science, The Ohio State University, 2011, Allied Medical Professions

The prevalence of food insecurity has increased over the past few years, and some studies have shown that food insecurity can have health implications associated with chronic diseases. Food insecure families rely on food pantries to meet their food needs. In addition to physical needs, social issues also influence health according to the socio-ecological model. Health students as future healthcare providers can bridge environmental considerations and social responsibility to promote health. The Health Belief Model states that beliefs mitigate actions, thus the aim of this study was to determine allied health students' beliefs regarding food pantry practices and their clients. Students enrolled in an Allied Health Management course at The Ohio State University were invited to respond to an online survey which consisted of 18 items with statements regarding foods provided in food pantries, distribution practices, and characteristics of food pantry clients. Survey items were scaled from 1 = strongly disagree to 5 = strongly agree. Descriptive statistics were used to analyze the data. Mean score for the item “Food pantry clients should be assured of safe food choices (sealed containers, prior to expiration dates)” was 4.7 + 0.6 (mean + SD), indicated that students nearly strongly agreed with this item. Students least agreed with the item “Food pantry clients are “Most food pantry clients are lazy” with a mean score of 1.9 + 0.8. Students were most divided regarding the item “There is no stigma in using a food pantry” with a mean score of 2.6 + 1.2. Most students were neutral regarding specific types of foods provided to clients, however were nearly strongly agree that foods should be balanced across food groups. Students were neutral regarding the item “Anyone coming to a food pantry requesting help should receive food” and nearly agree with the item “Potential clients should prove they need food from the food pantry. In conclusion, allied health students may or may not (open full item for complete abstract)

Committee: Kay Wolf PhD (Advisor); Jill Clutter PhD (Committee Member); Diane Habash PhD (Committee Member) Subjects: Health Education; Nutrition

Master of Science (MS), Ohio University, 2010, Food and Nutrition (Health and Human Services)

This study identified differences between those receiving fresh produce during three winter months (experimental group) compared to those receiving gift cards (comparison group) regarding produce intake and behaviors, household food insecurity status, social capital, perceived diet, and perceived health status. The relationship of household food security status to the social capital, personal characteristics, such as level of education, perceived health, perceived diet, and the psychosocial indicators of, and intake behaviors related to, fruits and vegetables, at the beginning and the end of the study was also examined. Sixty-one individuals participated in the study. Intervention group participants were 33 food pantry users who completed a pretest, received locally grown produce over 3 months ($60 value), and completed a posttest. Control group participants were 28 food pantry users who completed a pretest, received supermarket gift cards ($60 value), and completed a posttest over that same time period. Differences were found in the perceived diet quality of intervention and control group participants, with intervention group participants perceiving a significantly higher diet quality at the end of the study as compared to control group participants. In addition, while no significant improvement in the produce intake was observed from pre- to postintervention for all participants, an improvement in household food security status was observed for the entire sample after completion of the study. For the entire sample at the onset of the study household food insecurity was associated with poor diet quality, self-efficacy, intention, enabling, and all domains related to fruit and vegetable psychosocial indicators, fewer servings of fruit, vegetables, and total produce, a lower 7-item behavior checklist score, poorer perceived health status, younger age, not having a garden, having more household adult members ≥ 19 years, and not having transportation to obtain food. A (open full item for complete abstract)

Committee: David Holben PhD (Advisor); Darlene Berryman PhD (Committee Member); George Johanson PhD (Committee Member) Subjects: Nutrition

Master of Science, Miami University, 2013, Family and Child Studies

This study examines food insecurity from the providers' perspective in a Midwestern county. To understand food insecurity in this county, an interview of the county choice food pantries and its food bank supplier was completed. Data included descriptive demographic data about the county residents, as well as interviews with both a director and front-line worker from the food bank and five choice food pantries from different townships in the county. The study examined the providers' perspective on how county residents experience food access and food insecurity barriers. The study focused on the process by which the food bank, food pantries and federal food assistance programs alleviate food insecurity and work towards self-sustained food security. I discussed study limitations and implications for practice, policy and research.

Committee: Sherrill Sellers (Committee Chair); Ann Fuehrer (Committee Member); Carolyn Slotten (Committee Member) Subjects: Agriculture; Developmental Psychology; Economic History; Economics; Families and Family Life; Health; Political Science; Psychology; Public Health; Public Health Education; Public Policy; Social Work; Welfare

Master of Science, The Ohio State University, 2012, Allied Medical Professions

Food insecurity is on the rise in the United States, and food insecure individuals are more likely to have diabetes than those who are food secure. Diabetes self-management may be impaired as a result of food insecurity, and there are limited studies that examine the effect food distributed by food pantries can have on the management of diabetes. A greater understanding of what types of foods provided by food pantries will be most beneficial to food insecure individuals with diabetes could have a significant impact on better meeting the individual's medical needs to assist diabetes control. The objective of this study was to identify both the positive outcomes and the challenges of receiving diabetes-friendly (low-glycemic index) food boxes developed for food insecure individuals with type 2diabetes using food pantries. The analysis is based upon three focus groups and one interview with participants of an on-going study, conducted from October through November 2012. An open-ended question thread was utilized during the focus groups and interview. The data was transcribed from the audio-recorded sessions and analyzed by identifying, coding, and categorizing primary patterns/themes in the data. Participants cited similar responses resulting in six overarching themes: (1) participants are grateful for the food boxes, (2) participants share food box items with multiple people, (3) participants provided support to the fellow group members, (4) participants noted exposure to new foods, (5) perceptions of diabetes health improved due to the food boxes, and (6) the process for pick-up affected participants' lives. The findings suggest the diabetes-friendly food boxes are beneficial for food insecure individuals with type 2 diabetes by exposing them to new food items and improving their diabetes management as stated by the participants. Also the findings indicate and increased need for supplemental information regarding food preparation and recipes as well as further diabet (open full item for complete abstract)

Committee: Kay N. Wolf PhD (Advisor); Diane L. Habash PhD (Committee Member); Colleen K. Spees PhD (Committee Member) Subjects: Nutrition

MS, University of Cincinnati, 2019, Allied Health Sciences: Nutrition

Objective: The “Most Diabetes and Health Friendly Shelves” Initiative was developed to assist choice food pantry clients improve food choices to prevent or manage diabetes or other diet-related chronic conditions. The objective this study was to explore the adoption and acceptability of the program and its impact on food choices and management of health conditions in food pantry clients and volunteers at an urban food pantry. Methods: A cross-sectional qualitative study was conducted using in-depth interviews. Thirteen pantry clients and six pantry volunteers completed the study after 9 months of the initiative beginning. Semi-structured questions were used to explore the overall perceptions of the shelves and the impact of the initiative on shopping and eating habits and diet-related chronic disease management. Interviews were recorded and transcribed. Transcripts were coded by two researchers independently using NVivo 12 and the codes were discussed until consensus was reached. Major themes were identified and summarized. Results: More than half of clients interviewed were female (n=7), and most of the participants were either non-Hispanic white (n=8) or Black American (n=5). Less than half had high blood pressure (n=6) and diabetes (n=3). Most clients favored the shelves due to their convenience having healthy items presorted and overall appealing design. Significant impacts on food choices and shopping behaviors were identified by clients with the common themes: becoming more selective to healthful foods during grocery shopping, more aware of the nutritional value of food specifically sugar and sodium content, and more reading Nutrition Fact labels. Several clients conveyed the positive impact the initiative had on management of a diabetes for themselves and their family members. On the contrary, a few clients expressed disinterest with the initiative due to not having diet-related chronic diseases. Volunteers had positive impressions of the shelves sug (open full item for complete abstract)

Committee: Seung-Yeon Lee Ph.D. (Committee Chair); Melinda Butsch-Kovacic Ph.D. (Committee Member) Subjects: Nutrition

MS, University of Cincinnati, 2018, Allied Health Sciences: Nutrition

Objective: The purpose of this study was to assess what methods are currently being used to promote MyPlate in pantries in Greater Cincinnati. Additionally, this study assessed current food organization and shelf labeling being used as well as the interest and feasibility of incorporating health screenings and coaching to pantry clients. Methods: This was a cross-sectional study using mixed methods. An online survey was conducted with 31 food pantry coordinators and ten food pantry sites were observed using an observation checklist. Photos and hand-drawn layouts of those pantries were collected as well. Results: Overall, MyPlate promotion was not a high priority for many pantries. While some written materials (pamphlets, brochures, posters, etc.) were provided to clients, only one participating pantry reported having nutrition education classes that address MyPlate. Organization of food and shelf labeling do not appear to be a high priority. Food pantries organized foods in unique ways based on their space and distribution methods. Sections were not always labeled and no pantries separated food by alternative options, regular vs. reduced sodium, reduced fat, etc. While several pantry coordinators expressed their interest in providing health screenings and coaching for clients, various barriers, such as limited space, funding, and lack of individuals to provide the services were identified. Conclusion: Few MyPlate promotional items were found in waiting areas and food pantries among those observed in Greater Cincinnati. Additionally, food organization and shelf labeling were not consistent across pantries and health screenings and coaching are not offered to clients. Implications: In order to address each of the study components, each pantry may need to address its own unique set of barriers and utilize available resources. Improving MyPlate promotion and organization and labeling strategies can begin with utilizing free internet resources or observing ot (open full item for complete abstract)

Committee: Seung-Yeon Lee Ph.D. (Committee Chair); Sarah Couch Ph.D. (Committee Member); Debra Krummel Ph.D. (Committee Member) Subjects: Nutrition

MS, University of Cincinnati, 2015, Allied Health Sciences: Nutrition

Background: Food pantry clients tend to be of low-socioeconomic status and are therefore at a greater risk for developing chronic diseases and having lower than average intakes of fruits and vegetables. Despite nutrition education interventions being effective at increasing the fruit and vegetable consumption of target populations, no studies have evaluated the effectiveness of a nutrition education program on the fruit and vegetable intake in adult food pantry clients. Objective: To evaluate the effectiveness of a nutrition education intervention on the fruit and vegetable consumption in adult food pantry clients using mixed methods (survey and photovoice). Methods: A quasi-experimental study was conducted with 21 adult food pantry clients in the intervention group, and 26 adult food pantry clients in the control group. Those in the intervention group attended a 4-week nutrition education program focused on fruit and vegetable consumption while those in the control group received no intervention. The effects of the intervention on the fruit and vegetable consumption and self-efficacy, outcome expectations, and self-regulation related to fruit and vegetable intake was assessed using a survey. In addition, photovoice was utilized to further evaluate the effectiveness of the nutrition education program in the intervention group only. Results: At baseline, the control group consumed significantly (p=0.0025) more fruit than the intervention group. After the nutrition education program, participants in the intervention group significantly (p=0.002) increased their whole fruit intake, while the control group did not. The change in the intervention groups' whole fruit intake was significant (p=0.002) compared to the change in the control group. There were no significant differences in the pre or posttest results within or between the groups in terms of their vegetable consumption, fruit juice consumption, self-efficacy, self-regulation or outcome expectations (open full item for complete abstract)

Committee: Seung-Yeon Lee Ph.D. (Committee Chair); Melinda Butsch-Kovacic Ph.D. M.P.H. (Committee Member) Subjects: Nutrition